Incidence of massive rebleeding from nonbleeding visible vessels in benign gastroduodenal lesions and prospective study in assessing the efficacy of endoscopic hemostasis with local ethanol injection for prevention of rebleeding
Chen, L.T.; Chen, C.Y.; Jan, C.M.; Wang, W.M.; Lan, T.S.; Chen, T.S.
Gaoxiong Yi Xue Ke Xue Za Zhi 5(3): 180-184
1989
ISSN/ISBN: 0257-5655 PMID: 2659816 Document Number: 347087
Twenty-seven patients presenting with massive upper gastrointestinal bleeding in whom endoscopy revealed nonbleeding visible vessels in benign gastroduodenal lesions were prospectively and nonrandomly allocated to receive endoscopic injection therapy with pure ethanol or conservative treatment. Those who received conservative therapy were used as a control group. The purpose of this study is to evaluate the incidence of massive rebleeding from the nonbleeding visible vessel which was defined by a more rigid criteria and to evaluate the efficacy of endoscopic pure ethanol local injection to prevent rebleeding. Nine out of the 10 (90%) controls had recurrent major bleeding, in contrast to the 2/17 (12%) of those who received hemostatic endoscopy (p less than 0.0002). Pure ethanol local injections also minimized further transfusion requirements (p less than 0.03). The complications of hemostatic endoscopy in this study are negligible. It is concluded that 1) by restrictive definition nonbleeding visible vessels in benign gastroduodenal lesions carry a high potential of recurrent massive bleeding; 2) rebleeding can be safely and effectively prevented by pure ethanol local injection.